BILLINGS, Mont. — In Sunday church pews, in the grandstands of the baseball game, in the checkout line of the big-box store, most of the people around you have gotten a prescription for painkillers in the past year.

In fact, there are 82 painkiller prescriptions for every 100 Montanans and more than 300 deaths from prescription drug overdoses in 2010 and in 2011.

We know this because governments and medical professionals have been keeping track of prescription drugs since it became clear that both the prescriptions and related deaths were skyrocketing.

From 1999 to 2010, the number of painkiller overdose deaths nationally quadrupled, according to the Centers for Disease Control.

Those 300 prescription drug deaths in Montana in 2010 outnumbered car crash deaths, according to the state Justice Department.

The state now requires that prescriptions for painkillers be registered with the state Board of Pharmacy.

The list, less than 2 years old, is 5 million prescriptions long and growing as more scripts for opioids like OxyContin, Dilaudid, Demerol and morphine are added.

Statistics suggest the state is gaining the upper hand on prescription drug abuse.

The number of prescription drug-related deaths in Montana was 109 in 2013, according to the state Department of Public Health and Human Services.

The number of people prosecuted for prescription drug crimes in Yellowstone County has fallen 70 percent from 2011 to 2013.

Still, there’s criticism from county attorneys that the state’s drug registry is so wrapped up in red tape that it’s difficult for law enforcement to use.

“I’ve accessed it a couple of times and had varying degrees of success,” said Wyatt Glade, Custer County attorney.

Accessing the list not only takes law enforcement involvement, but prosecutor involvement as well because it takes an investigative subpoena.

Montana’s privacy laws make the process so difficult that the drug registry hasn’t been a go-to source for law enforcement, which isn’t to say that the registry hasn’t curbed prescription drug abuse.

In Yellowstone County, the number of criminal cases of fraudulently obtained dangerous drugs dropped from 42 the year before the registry was created to 13 last year, said Scott Twito, Yellowstone County attorney.

But Twito said he assumes the decline is because people shopping for prescriptions are being turned away by doctors and pharmacists.

The Board of Pharmacy does receive subpoena requests, said Marcie Bough, executive director. Since the registry went live in October 2012, prosecutors have received responses to 264 subpoenas.

“We consider it to be very successful in terms of how far we have come at this stage,” Bough said.

But only 24.4 percent of health care providers eligible to use the list actually do, according to a May report by the Montana Board of Pharmacy to state legislators.

The 2015 Legislature will have to revisit the registry to determine whether to change the fee that supports the $300,000 program. Making the registry more useful is expected to be part of that discussion.

Wyoming started its registry in 2003. It took several years before the majority of the state’s medical professionals were using the list, but most now do, said Mary Walker, the state’s Pharmacy Board executive.

Large pharmacy chains concerned about liability in prescription drug cases played a big role in boosting use, Walker said.

“One of the best uses, officers say, is getting reports when they’re starting to investigate a death,” Walker said. “Say a coroner has a case where there are prescriptions bottles. They can decide whether to rule that out.”

Wyoming law requires the Pharmacy Board to report suspected illegal activity to police. Montana law does not.

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